Authors
Hamza Yildiz, Kasim Akay, Bengisu Asut, Huseyin Durukan, Hakan Aytan, Faik Gurkan Yazici
Published in
Irish journal of medical science. Jul 09, 2026. Epub Jul 09, 2026.
Abstract
Standard postoperative care for major gynecologic and obstetric surgery traditionally involves a 48-hour observation period. However, extraordinary crises such as the COVID-19 pandemic and the 2023 Kahramanmaraş earthquake necessitated an accelerated 24-hour discharge protocol to preserve hospital capacity.
This study aims to evaluate whether a 24-hour early discharge protocol is non-inferior to the conventional 48-hour standard regarding clinical complications.
In this retrospective cohort study, data from 11,670 patients (2010-2024) were analyzed. Patients were categorized into Pandemic (n = 2,924) and Earthquake (n = 1,194) groups (24-hour discharge), and a Control group (n = 7,552; 48-hour discharge). Primary outcomes included surgical site infection (SSI), urinary tract infection (UTI), wound dehiscence, and hemorrhagic complications within 30 days.
Non-inferiority was established for SSI (4.3% and 4.4% vs. 4.1%), UTI (3.5% and 3.6% vs. 3.3%), and wound dehiscence (1.4% and 1.3% vs. 1.3%). Multivariable regression confirmed that hospitalization duration was not an independent predictor of SSI (p > 0.500), whereas obesity (OR: 1.91; p < 0.001) was the primary risk factor. Hemorrhagic complication results remained inconclusive due to insufficient statistical power.
A 24-hour postoperative discharge protocol is non-inferior to the 48-hour standard for most major complications following benign surgery. These findings suggest that patient-intrinsic factors, specifically BMI, drive infection risk more than the length of hospital stay.
PMID:
42423912
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.
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